1 Project Summary 2 Cerebral Palsy (CP) is a group of disorders attributed to non-progressive alterations occurring in the brain dur- 3 ing fetal and newborn development. These alterations affect movement, development and posture, causing 4 significant lifetime functional limitations. CP is the most common motor disorder in children, affecting 500,000 5 individuals in the US alone. Children with CP are commonly affected by gait impairments. One of the most 6 common impairments is equinus gait, or ?toe-walking?, which is characterized by predominantly plantarflexed 7 feet during the whole gait cycle. Different interventions are available to treat equinus gait in children with CP 8 and include physical therapy, orthoses, botulinum toxin injections and surgery. To determine which intervention 9 is most appropriate to restore mobility for a given patient, periodic gait evaluations are performed in the clinic. 10 This Phase I SBIR proposal will develop a wearable system (Home Evaluation, Assessment, Rating and Train- 11 ing of Gait, HEART-Gait system) that continuously monitors and analyses simple gait parameters in children 12 with CP outside the clinical laboratory and during normal daily activities, which will provide clinically useful out- 13 comes data not currently available and critical diagnostic data for determining intervention timing. With access 14 to continuous data, the medical team is better informed and can effectively plan treatment, thus improving the 15 quality of care and the lives of children with CP and their families. Specific Aims are 16 Aim 1. Develop working prototype of HEART-Gait: Milestones are: 17 MS1: Veristride will optimize sensor selection and placement; construct prototype data acquisition hardware, 18 firmware and software. Months 1-2. 19 Aim 2. Iteratively design HEART-Gait system: Milestones are: 20 MS2: Veristride and the Spaulding team will work closely to modify the prototype system to make it suitable for 21 monitoring toe-walking in children with CP. Months 2-5. 22 MS3: The Spaulding team will interview 10 clinicians (unaffiliated with the project) and 10 families (guardians 23 and children) to gather their feedback about the HEART-Gait system. Months 2-5. 24 Aim 3. Evaluate the feasibility of HEART-Gait: Milestones are: 25 MS4: The Spaulding team will recruit 20 children (5-12 years) with CP and toe-walking pattern. Data will be 26 collected simultaneously from HEART-Gait and camera-based motion capture. Months 5-10. 27 MS5. The Spaulding team will derive a clinical index of the severity of toe-walking based on ankle biomechan- 28 ics data collected using the camera-based motion capture system. Months 6-11. 29 MS6. Veristride will collaborate with Spaulding team to develop machine-learning algorithms to estimate toe- 30 walking severity and characterize accuracy. Months 7-12. 31